A 20-Year Population-Based Study

Funding Information: Coordenação de Aperfeiçoamento de Pessoal do Nível Superior—CAPES. Code: 001. Publisher Copyright: © 2022 by the authors.Acute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space–time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman’s correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.publishersversionpublishe

Is the WHO End TB Strategy at Risk?

Publisher Copyright: Copyright © 2022 Souza, Paz, Sales, Jesus, Tavares, Lima, Sousa, Melo, Carmo, Souza and Bezerra-Santos.Background: In 2014, the World Health Organization (WHO) launched the “post-2015 End TB strategy”, that aims to end the global tuberculosis (TB) epidemic by 2030. However, the COVID-19 pandemic has severely impacted global public health and the strict measures to control the coronavirus spread can affect the management of other diseases, such as TB. Herein, we aimed to assess the impact of the COVID-19 pandemic on the diagnosis of TB in Brazil, during 2020. Methods: We carried out an ecological and population-based study, using spatial analysis techniques. The variables used were the new cases of TB, pulmonary tuberculosis (PTB), and also baciloscopy-positive (BP) cases in Brazil between 2015 and 2020. The percentage of changes (% change) was calculated to verify if there was an increase or decrease of TB cases in 2020, along with time trend analyses given by Joinpoint regression model. Also, interrupted time series analyses were used to assess the trend of TB diagnosis before and after the onset of the COVID-19 in Brazil. Spatial distribution maps were elaborated, considering the % change of each Brazilian state. Findings: Data analyses showed a reduction in the diagnosis of TB (−8.3%) and PTB (−8.1%) in Brazil after the irruption of the COVID-19 pandemic. Likewise, 22 states depicted a reduction in TB diagnosis. An expressive reduction of BP cases (−17.1%) was also observed. Interestingly, interrupted time series analysis showed decline in TB and PTB diagnoses from March 2020. Spatial analyses revealed that all states had a progressive reduction of TB, PTB and PB cases, from March on, with the highest percentages of reduction in December (−100% to −75%). Interpretation: Taken together, our analyses demonstrated a reduction in TB diagnosis after the irruption of the COVID-19 pandemic in Brazil and its regions, signaling a serious impact on the WHO “End TB Strategy” global plan.publishersversionpublishe

Aspectos relacionados com a positividade para a esquistossomose: estudo transversal em área de baixa prevalência do estado de Alagoas, 2020

Objective: To analyze aspects related to positivity for schistosomiasis in an area of ​​low prevalence in Brazil. Methods: Cross-sectional study, carried out in the first half of 2020, where proportion of positivity was analyzed according to the number of Kato-Katz slides, the diagnostic performance of the test and the creation of a positivity estimation factor from the data of the Information from the Schistosomiasis Surveillance and Control Program (SISPCE). Results: 2,088 slides from 348 individuals were analyzed, with proportion of positivity of 11.8%, 26.7% and 31.0% for 1, 4 and 6 slides analyzed, respectively. There was excellent agreement (Kappa = 0.91) between the reading of 4 and 6 slides. An underreporting of 2.1 times was estimated in the SISPCE data. Conclusion: Increasing the number of blades increased the positivity of Kato-Katz, which can contribute to maximize the control of the disease as a public health problem.Objetivo: Analisar aspectos relacionados com a positividade para esquistossomose em área de baixa prevalência, no Brasil. Métodos: Estudo transversal, realizado no primeiro semestre de 2020, quando foram analisadas a proporção de positividade, em função do número de lâminas de Kato-Katz, o desempenho diagnóstico do teste e a estimação da positividade a partir dos dados do Sistema de Informação do Programa de Vigilância e Controle da Esquistossomose (SISPCE). Resultados: Foram analisadas 2.088 lâminas de 348 indivíduos, sendo a proporção de positividade de 11,8%, 26,7% e 31,0% para 1, 4 e 6 lâminas analisadas, respectivamente. Houve concordância excelente (índice Kappa = 0,91) na comparação entre as leituras de 4 e 6 lâminas. Foi estimada subnotificação de 2,1 vezes nos dados do SISPCE. Conclusão: Ampliar o número de lâminas aumentou a positividade do Kato-Katz, o que pode contribuir para maximizar o controle da doença enquanto problema de Saúde Pública

Impact of the COVID-19 pandemic on the diagnosis of tuberculosis in Brazil: Is the WHO end TB strategy at risk?(Front. Pharmacol., (2022), 13, (891711), 10.3389/fphar.2022.891711)

Publisher Copyright: © 2022 Rosário Souza, Silva da Paz, dos Santos Sales, Hilario de Jesus, dos Santos Tavares, Almeida Lima, Lopes Sousa, Vieira de Melo, Feliciano do Carmo, Freire de Souza and Bezerra-Santos.In the published article, there was an error in the Funding statement. The manuscript was published without due mention of the funding agency. The correct Funding statement appears below. “Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal, ref. UID/04413/2020.” In addition, the article was published without including the acknowledgments. The correct Acknowledgments statement appears below.publishersversionpublishe

Reduced HIV/AIDS diagnosis rates and increased AIDS mortality due to late diagnosis in Brazil during the COVID-19 pandemic

Abstract The COVID-19 pandemic has severely affected global health, leading to the suspension of numerous routine healthcare services and posing challenges in efforts to control other diseases, such as HIV/AIDS. This study aimed to assess the impact of the COVID-19 pandemic on HIV/AIDS diagnoses and mortality rates in Brazil during 2020 and 2021. The percentage change was calculated to determine whether there was an increase or decrease in HIV/AIDS diagnoses and mortality, considering the average numbers from the last 5 years. Additionally, a Joinpoint regression model and an interrupted time series analysis were applied to assess time trends before and after the onset of the pandemic. Lastly, choropleth maps were prepared. We observed a reduction of 22.4% (2020) and 9.8% (2021) in the diagnosis of HIV/AIDS in Brazil. Conversely, there was a significant increase in the percentage change of late diagnosis of AIDS deaths in 2020 (6.9%) and 2021 (13.9%), with some states showing an increase of over 87%. Decreasing time trends in the diagnosis of HIV/AIDS were identified before the pandemic in Brazil, especially in the Southeast and South regions, and then time trends stabilized after including the pandemic years. Along with the dissemination of COVID-19, there was a reduction in the diagnosis of HIV/AIDS and an increase in late diagnosis AIDS deaths, signaling a serious impact of the pandemic on HIV/AIDS control strategies in Brazil. Therefore, we highlight the need for continuous efforts to control both diseases, that is, maintaining regular health services even in crisis situations